Understanding Anxiety: What It Is and What It Isn’t

Anxiety and Fear vs Normal Stress

Anxiety and fear are innate response in humans. Both of them present with similar symptoms, as they are closely related phenomena. However, there is a subtle but important difference between the two.

A response to a situation that is perceived as threat and is happening right now is called fear. On the other hand, similar responses to imagined or perceived situations that may happen in the immediate or delayed future is called anxiety. Both of these are our evolutionary responses that have helped us stay better prepared. However, when these emotions become too frequent, intense, or start interfering with our daily activities and life goals, like at work, in our relationships, or impeding our personal growth, they may be symptoms of a disorder.

Psychiatric conditions are not completely different from normal emotional states. They are just more severe and persistent, leading to distress or dysfunction in everyday life.

Types of Anxiety or Fear-Related Disorders

Anxiety or fear-related disorders constitute a wide variety of diagnoses including Generalised Anxiety Disorder (GAD), Panic Disorder, Agoraphobia, Specific Phobia, Social Anxiety Disorder (SAD), Separation Anxiety Disorder, and Selective Mutism.

These disorders are grouped together based on the common features that they all share such as excessive fear, persistent worry, and avoidance behaviours associated with the fear or worry.

These are called disorders because the fear and worry can result in any of the following situations: -

1.       Responses that are out of proportion to the actual situation

2.       Responses that are difficult or impossible to alter or control

3.       Responses that cause significant distress or problems in daily life

While each of the disorder has unique characteristic, they all involve a heightened state of emotional and physical alertness that becomes disruptive when they interfere with everyday functioning.

Symptoms of anxiety disorders

The symptoms related to anxiety and fear disorders can be understood by dividing them into three different domains.

Three Domains of Anxiety Symptoms

Physically, one can feel like their heart is racing, experience shortness of breath, experience sweating, trembling of hands, dizziness, or stomach discomfort. Physical symptoms of anxiety can also present in a myriad of other physical symptoms, which may not be apparent at first.

Emotionally, the individual often feels tensed, restless, overwhelmed, or constantly on edge. Some individuals feel detached from themselves or their surroundings for some time.

Cognitive responses may include persisting worry, difficulty in focussing one’s attention on any task, overthinking about the worst-case scenario, or a sense of losing control. Individuals may filter thoughts such that they negatively appraise their surroundings, take excessive responsibility, or seek reassurance or comfort from people or behaviors. Instinctively, individuals may also recognize situations which lead to such emotional responses, leading to avoidance. Thus, over time, behavioral patterns develop in response to these anxious thoughts, that may also cause discomfort and dysfunction.

These symptoms can vary in intensity but are often interconnected. All the above symptoms may feed into one another making the experience more distressing. Hence, the presence of a combination of the above symptoms is required to reach a diagnosis.

How is each one different?

Although each of the disorder enlisted under anxiety and fear-related disorders have common symptoms, they also differ in many ways. A person suffering from Generalized Anxiety Disorder (GAD) may worry constantly about everyday situations, which may be out of proportion to the stimuli. People with GAD may feel constantly on edge and have non-specific anxiety which cause dysfunction in various aspects of their lives.

When suffering from panic disorder, one can experience sudden and frequent panic attacks, which are typically described as intense waves of fear that appear without warning and are often accompanied by intense physical symptoms.

Agoraphobia is the fear of being in places or situations where the person might feel that escape is difficult. For e.g., they may avoid crowded areas, or public transport. Specific Phobia is a strong, irrational fear of a particular object or situation, like heights, animals, or flying.

Social Anxiety Disorder (SAD) is the fear of being judged, embarrassed, or rejected in social or situation where performance is needed. Separation Anxiety is triggered by thought or situations that may result in being away from home or loved ones. This is more common in children but has also been reported in adults. Selective Mutism is also more common in children, where they are unable to speak in certain social settings despite speaking comfortably in others.

These differences in triggers that cause the onset of the symptoms help in making a precise diagnosis and personalise the therapeutic approach.

Recognising the different form of anxiety and how they affect a person physically, emotionally, and cognitively is the first step towards recovery. With proper understanding and treatment, any one can learn to manage these feelings and lead a fulfilling life.